Treatment outcomes of IgG4-producing marginal zone B-cell lymphoma: a retrospective case series

Sumii, Yuichi; Asada, Noboru; Sato, Yasuharu; Ohshima, Koh Ichi; Makita, Masanori; Yoshimoto, Yusuke; Sogabe, Yuka; Imajo, Kento; Meguri, Yusuke; Ennishi, Daisuke; Nishimori, Hisakazu; Fujii, Nobuharu; Matsuoka, Ken; Yoshino, Tadashi; Maeda, Yoshinobu

doi:10.1007/s12185-020-02968-w

Cited by 6 publications

(9 citation statements)

References 26 publications

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“…Although lymphadenopathy frequently occurs in IgG4-RD, lymph nodes are often affected in autoimmune diseases, multicentric Castleman's disease, hematological malignancies such as malignant lymphoma and lymph node metastasis of cancers. And infiltration of IgG4-positive lymphocytes is detected in some patients with B cell lymphoma [20] and with cancers of digestive organs [21,22]. Therefore, involvement of a single lymph node was not included as a criterion for IgG4-RD.…”

Section: Clinical and Radiological Featuresmentioning

confidence: 99%

The 2020 revised comprehensive diagnostic (RCD) criteria for IgG4-RD

Umehara

Okazaki

Kawa

et al. 2021

Modern Rheumatology

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IgG4-related disease (IgG4-RD) is a fascinating clinical entity first reported in this century in Japan, and includes a wide variety of diseases, such as formerly named Mikulicz's disease (MD), autoimmune pancreatitis (AIP), interstitial nephritis, prostatitis and retroperitoneal fibrosis. The Japanese IgG4 team organized by the Ministry of Health, Labor and Welfare (MHLW) of Japan has published the first criteria, comprehensive diagnostic (CD) criteria for IgG-RD 2011. Thereafter, IgG4-RD has been accepted widely and many cases have been reported from all over the world. Several problems have arisen in clinical practice, however, including the difficulty obtaining biopsy samples, and the sensitivity and specificity in cut off level of serum IgG4 and impaired immunostaining of IgG4. Given these situations, the Japanese IgG4 team has updated the 2011 comprehensive diagnostic criteria for IgG4-RD and propose the 2020 revised comprehensive diagnostic (RCD) criteria for IgG4-RD, which consists of 3 domains; 1) Clinical and radiological features, 2) Serological diagnosis and 3) Pathological diagnosis. In addition, the new pathological diagnosis is composed by three sub-items including storiform fibrosis and obliterative phlebitis.

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Section: Clinical and Radiological Featuresmentioning

confidence: 99%

The 2020 revised comprehensive diagnostic (RCD) criteria for IgG4-RD

Umehara

Okazaki

Kawa

et al. 2021

Modern Rheumatology

Self Cite

304

226

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“…We speculated that the IgG4‐related subtype of IRF can be manifested malignantly. It has been reported that cells producing IgG4 could be malignant 12 . Moreover, K‐ras mutations in the pancreas, the bile duct, and the gallbladder in autoimmune pancreatitis have been observed 13 .…”

Section: Discussionmentioning

confidence: 99%

“…It has been reported that cells producing IgG4 could be malignant. 12 Moreover, K-ras mutations in the pancreas, the bile duct, and the gallbladder in autoimmune pancreatitis have been observed. 13 These suggest the possibility that IgG4-RD may be complicated by or related to the development of malignant diseases.…”

Section: Discussionmentioning

confidence: 99%

Differences of clinicopathological features between IgG4‐related and non‐IgG4‐related idiopathic retroperitoneal fibrosis

Wang

et al. 2022

Int J of Rheum Dis

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Objective: To evaluate the clinical and pathological features of IgG4-related and non-IgG4-related idiopathic retroperitoneal fibrosis (IRF) according to the latest classification criteria for IgG4-related disease in 2019. Methods:Patients with IRF confirmed by histological examination from our hospital between 2000 and 2020 were selected in this study. Medical records of all patients were reviewed by independent researchers. Retroperitoneal specimens were obtained for hematoxylin & eosin staining, elastic-collagenous fiber staining, and immunohistochemical analysis. The clinical and pathological features between IgG4-related and non-IgG4-related IRF were analyzed.Results: A total of 105 patients were included with 77 in the IgG4-related group and 28 in non-IgG4-related group. The ratio of male to female patients and the incidence of acute renal failure were significantly higher in the IgG4-related group than in the non-IgG4-related group. Elevated erythrocyte sedimentation rate and C-reactive protein were more common and the recurrence rate was significantly higher in the IgG4-related group than in the non-IgG4-related group. Radiographically, the ureter was more easily involved by retroperitoneal soft tissue in the IgG4-related group.Histologically, there were no significant differences in the incidence of dense lymphoplasmacytic infiltration, storiform fibrosis, and obliterative phlebitis between the two groups except for the IgG4 staining.Conclusions: Idiopathic retroperitoneal fibrosis can be classified into IgG4-related and non-IgG4-related subtypes. There were no significant pathological differences between the two subtypes of IRF, except for the IgG4 staining. Patients with the IgG4 subtype tended to be more likely to be male, have a higher inflammatory index, and be more likely to have recurrence.

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“…In a study by Brenner et al, IgG4 expressing MALT lymphoma showed an excellent prognosis [24]. Sumii et al showed that the standard treatment for marginal zone B-cell lymphoma is appropriate for IgG4-producing MALT lymphomas in a cases series of seven patients, including five cases of ocular adnexal MALT lymphomas [25]. However, Lee et al identified that 10% (10/50) of the recruited non-conjunctival ocular adnexal MALT lymphoma patient was positive for IgG4 and showed characteristic histological features such as extensive plasma cell infiltration and dense fibrosis.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathologic Characteristics Associated with Prognosis in Ocular Extranodal Marginal Zone B Cell Lymphoma

et al. 2022

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Background and Objectives: Extranodal marginal zone lymphoma of the mucosa-associated lymphoid tissue (MALT) type is the most common subtype of the ocular adnexal lymphoma. Despite its excellent prognosis, some patients experience partial remission or progressive disease. We aimed to evaluate clinicopathologic differences in the treatment responder group by comparing complete remission (CR) and non-complete remission (non-CR). Materials and Methods: This study retrospectively reviewed 48 patients who were diagnosed with ocular adnexal MALT lymphoma at Ulsan University Hospital between March 2002 and August 2018. Patients who were followed up for less than 6 months were excluded. Histologic and clinical features were analyzed. The patients were divided into two groups: CR and non-CR. Results: Among the 48 patients, 33 achieved CR and 15 achieved non-CR during the median follow-up period of 40.00 months (range, 7–109 months). In univariable analysis, more patients tend to undergo treatment in the CR group, and post-radiotherapy (post-RT) SUVmax, PET and serum lactate dehydrogenase (LDH) levels were higher in the non-CR group (p = 0.043, p = 0.016, and p = 0.042, respectively). In a multivariable analysis, only application of treatment, including radiotherapy or chemotherapy with immunotherapy, was related to CR (odd ratio 7.301, 95% confidence interval 1.273–41.862, p = 0.026). In subgroup analysis according to the site of involvement, none of the variables were significant except for the post-RT SUVmax of PET and level of serum LDH in the non-conjunctiva group (p = 0.026, and p = 0.037, respectively). Seven (14.6%) patients had a recurrence, and those with a recurring site other than the primary site had a higher Ki-67 labeling index, although it was not statistically significant (9.56% vs. 18.00%, p = 0.095). Conclusions: Although belonging to the early stages, the non-CR rate was high in patients with high serum LDH levels, and recurred patients had higher Ki-67. Thus, considering active treatment is recommended in this group of patients.

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Treatment outcomes of IgG4-producing marginal zone B-cell lymphoma: a retrospective case series

Cited by 6 publications

References 26 publications

The 2020 revised comprehensive diagnostic (RCD) criteria for IgG4-RD

The 2020 revised comprehensive diagnostic (RCD) criteria for IgG4-RD

Differences of clinicopathological features between IgG4‐related and non‐IgG4‐related idiopathic retroperitoneal fibrosis

Clinicopathologic Characteristics Associated with Prognosis in Ocular Extranodal Marginal Zone B Cell Lymphoma

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